VALSALVA, ANTON MARIA

(b. Imola, Italy, 17 June 1666; d. Bologna, Italy, 2 February 1723)

anatomy.

Valsalva came from a distinguished and well-to-do family. The son of Pompeo Valsalva, a goldsmith, and Caterina Tosi, he was the third of eight children. Valsalva was educated by the Jesuits in the humanities, mathematics, and natural sciences, the latter arousing his interest in animal morphology and entomology. He subsequently moved to Bologna, where he studied philosophy with Lelio Trionfetti, mathematics with Pietro Mengoli, and geometry with Rodelli.

Valsalva may be considered a Galilean through Borelli and thence through Malpighi, founder of microscopic anatomy and Valsalva’s teacher at Bologna University. Malpighi deeply respected Valsalva, who was his favorite pupil and who greatly admired Malpighi.

On 10 June 1687, Valsalva became a doctor of medicine and philosophy, defending the dissertation “Sulla superiorità delle dottrine sperimentali.” His name was then entered on the roll of Bolognese doctors and, with Santi Giorgio, Guglielmini, Giacomo Beccari, and Albertini, he began to attend scientific meetings at Eustachio Manfredi’s house that led to the founding of the Accademia degli Inquieti. In 1697 he became public engraver of anatomy, and in 1704 he published De aure humana tractatus . A year later Valsalva was named lecturer and demonstrator in anatomy, a post he held for the rest of his life.

Valsalva was devoted to teaching and scientific research, as well as to the practice of medicine. He spent much time in the anatomical amphitheater, the unhealthy air of which affected his health. Seized by such a furor studendi that he even made an organoleptic evaluation of exudates, Valsalva observed that the serum produced by gangrene was so acrid that, after tasting it, its extreme sourness irritated the papillae of his tongue for an entire day.

Valsalva’s scientific integrity was noteworthy. When he was elected, with Vittorio Stancari, by the Bologna Academy as censor of the first volume of Morgagni’s Adversaria anatomica, he asked for time in order to be able to give a considered and precise opinion. When the objection was raised that this would delay publication of the book, Valsalva replied, “That’s how I am . . . . I love Morgagni, but I love the truth more.”

On 22 April 1709, at the age of forty-three, Valsalva married Elena Lisi, the seventeen-year-old daughter of a noble Bolognese senatorial family; they had six children, three of whom died young. In 1721, during a consultation with Morgagni in Venice, he suffered a temporary dyslalia, a symptom of the fatal apoplexy that struck him two years later.

Valsalva’s famous De aure humana tractatus, with the anatomical letters that constitute an extensive commentary, is provided with plates that clearly illustrate the parts of the ear. The preparation of these drawings was probably influenced by Eustachi’s plates, which Valsalva greatly admired. His strongest incentive for devoting attention to the human ear probably came from Galileo’s new methodological approach and from his own interest in revising acoustics.

The treatise is in two parts, each divided into three chapters; the first part is mainly anatomical and the second physiological, in the Galenic sense of the usefulness of the individual parts. Valsalva divides the ear into the outer, middle, and inner parts. He provides the first detailed and precise description of the outer auricular muscles, based on a wax cast of the external auditory duct, and reproduces its course and diameters. In the middle ear he clearly illustrates the hammer and the tube, which he called the Eustachian tube, in which he recognizes cartilaginous, membranous, and bony components, as well as the muscles of the bones in the middle ear. He describes the morphology of the pharyngeal musculature and the muscle fasciae controlling the Eustachian tube, thus anticipating the concept of the unity of otorhinopharyngeal pathology from the morphological standpoint. (The importance of nasopharyngeal conditions in relation to diseases of the ear is fully recognized to day.) He next gives careful measurements of the diameter of the eardrum in relation to diseases of the ear is fully recognized today.) He next gives careful measurements of the diameter of the eardrum in relation to important formations, such as the windows of the labyrinth wall and the semicircular canals. he was the first to use the term “labyrinth” for the whole of the inner ear, although his idea of the membranous labyrinth was still confused (he did, however, recognize the existence of the labyrinthine liquid).

Valsalva’s treatment of the physiology of hearing contains some aspects of particular interest. He emphasizes the usefulness of the structure of the pinna, the auditory tube, and the ceruminous glands. Valsalva does not attribute special importance to the eardrum; in fact, hearing continues even if the membrane is perforated. In the transmission of sound greater importance is given to the bones of the middle ear, considered as a series of levers transmitting the sound to the labyrinth. The function of the labyrinth, similar to that described by Duverney, is distinguished in Valsalva’s conception by his failure to consider the lamina cochleae or the semicircular canals as organs that perceive sound; rather, he attributes this function to the zonae sonorae, interpreted as the ultimate branches of th auditory nerve. The semicircular canals, as well as the cochlea, are viewed as purely acoustic organs, in accordance with a theory valid until the early nineteenth century. For Valsalva, as for Socrates, teh sense of hearing can receive asll sounds without becoming overloaded.

Valsalva was an extremely skilled anatomist and pathologist, a fine physician, and an excellent surgeon for a quarter-century in the Bolognese hospitals, especially Sant’ Orsola. He was responsible for establishing the hospital institutes and for regulating the courses of study. As a surgeon he anticipated the importance of nephrectomy and splenectomy, and did work in ophthalmology, rhinology, and vasal and tumor surgery.

The procedure described in De aure and revived by Morgagni in De sedibus, which consists of making the patient exhale violently with mouth and nose closed, is still known as Valsalva’s test and has acquired importance in modern cardiovascular sympotomatology. It was originally used to remove foreign bodies from the ear and to improve hypacusis.

Valsalva has a place in the history of psychiatry for having been among the first to call for, and in part to implement, humanitarian treatment of the insane, preceding Vincenzo Chiarugi and Philippe Pinel. He considered madness to be analogous to organic disease.

BIBLIOGRAPHY

In addition to De aure humana tractatus (Bologna, 1704), a complete edition of Valsalva’s writings, edited by Morgagni, was published posthumously in 2 vols. (Venice, 1740)

The first and fundamental biography also was written by Morgagni, De vita et scriptis Antonii Mariae Valsalvae commentariolum (Venice. 1740). See also the collection Terzo Centenario della nascita di Antonio Maria Valsalva (Imola, 1966); G. Bilancioni, “La figura e l’opera di Valsalva,” in his Sulle rive del Lete (Rome, 1930), 77-100; P. Capparoni, “Antonio Maria Valsalva,” in Profili bio-bibliografici di medici e naturalisti celebri italiani dal secolo XV al secolo XVIII (Rome, 1932), 92-94; and P. Ravanelli, A. M. Valsalva (1666-1723) anatomico-medico-chirurgo-primo psichiatra (Imola, 1966).

Loris Premuda